World AIDS Day 2018
World AIDS Day: Celebrating the 10th anniversary of the first HIV- positive to HIV-positive kidney transplant
In commemorating World AIDS Day, Groote Schuur Hospital will celebrate the 10th anniversary of the first HIV- positive to HIV-positive kidney transplant.
The HIV-positive transplantation programme has been a necessary and positive initiative in South Africa – a country with one of the highest incidences of HIV infection in the world with an increasing need for HIV-positive patients with kidney failure who require dialysis. The challenge with dialysis in South Africa in the state sector is that it is limited to good transplant candidates. Sadly, up to 2008 it was believed that HIV positive patients would not be good transplant candidates. This meant that they were not accepted onto dialysis programs in the state sector. The decision to transplant HIV-positive patients with HIV-positive kidneys was not taken lightly. This was a very difficult decision made by transplant surgeon, Professor Elmi Muller, who needed to balance the views of medical community, ethics, risks and rights of patients.
Nevertheless, Prof. Muller started her HIV-positive transplant programme in 2008 and in September of that year the first HIV-positive donor was used to transplant a kidney into two HIV-positive recipients. Ten years later, 51 HIV-positive recipients have received kidneys from HIV-positive donors. In 2010, dialysis and transplantation became more readily available to HIV-positive patients however resources are still severely constrained.
“Over the last 10 years we have employed a research team to investigate risk and outcomes in patients enrolled in the HIV transplant program. We have looked at risk of superinfection (transmission of a new and possibly resistant strain of HIV from donor to recipient), kidney rejection, kidney failure and death. The outcome of kidney transplantation in our HIV-positive patients has recently been reviewed and is in line with results from high-risk recipients receiving HIV-negative donors. It has also been shown that there is no risk of superinfection in well-control patients on ART. The positive outcomes have also been attributed to good donor selection and robust clinical monitoring and support post transplantation,” said Prof Muller.
Prof Muller and her team will continue to drive and monitor the programme to ensure that patients can be provided with kidneys from healthy donors so they can live healthy and happy lives.
About 30 former patients who had the operations will be attending the 10th anniversary celebration at GSH. One such patients is Nombuyiselo Skafu from Port Elizabeth whose transplant was done in July 2015. The transplant improved the quality of her life as she was later able to take part in the transplant games.
Western Cape Government: Health
Groote Schuur Hospital
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